Our Little Miracles Have Arrived!

Most of you probably already know that we welcomed our beautiful girls into the world yesterday morning, at 30 weeks gestation. Nate and I are loving being Daddy and Mommy and want to thank everyone for all the prayers and support throughout this entire process!

Friday night, I was having some abdominal cramping, which I initially attributed to a spicy Qdoba meal that I ate that evening. Around 11:30, when it hadn't gone away, I asked my nurse to connect me to the monitor, which showed I was having regular contractions. At first, they pretty much just felt like my stomach was tightening (similar to any contractions I had previously had), but as the night went on, they became more and more uncomfortable. By 2am, I was so uncomfortable that I got a strong dose of pain meds, and I was able to sleep for about an hour before the meds wore off and I was awake and in some serious pain again. I got another dose of pain meds, and they put me on magnesium again to see if they could stop or slow the contractions. The resident told me she had a feeling we were going to have our babies that day, which was pretty hard for Nate and me to hear, considering we were hoping to make it four more weeks before having babies.

The magnesium did slow the contractions down, but I was still having them regularly and they were pretty uncomfortable. Right away at 7am, I was seen by the high risk doctor, who wanted to wait it out a few more hours but told me he had a hunch we'd be having babies by the end of the day. My discomfort kept getting worse and worse, and when I started bleeding a couple hours later (sorry, TMI), the decision was made to proceed with a c-section.

Although the surgery wasn't considered an emergency, I was prepped and brought to surgery rather quickly after deciding it was time to deliver. I didn't have much time to process what was about to happen! Thankfully, we had been prepared for what a premature delivery would look like when we met with the neonatologist only a few days prior, so we had an idea of what to expect.

The surgery went well. I did get to hear a tiny, pathetic little cry coming from one of my babies as she made her entrance into the world. Knowing she was breathing was so reassuring! As soon as the babies were delivered, they were taken into the next room where there was a NICU team ready to stabilize each of them. At that point, Nate left me to be with the newest loves of his life, Evelyn Joy and Sophie Grace.

The process of putting me all back together felt like it took forever, but Nate and my amazing nurses went back and forth between the babies and me and kept me informed of how the babies were doing. The babies were breathing on their own, but were hooked up to CPAP to help with their respiratory effort. This was not a surprise to us. After the initial phase of my recovery, my nurses wheeled me over to the stabilization room so I could catch a quick glance at my babes before they were wheeled down to the NICU... they were so beautiful!

During recovery, both sets of grandparents also arrived. After grabbing lunch, Nate took them to the NICU to meet their very first grandbabies! All four of them are as smitten with the girls as Nate and I are. The Grandpas and Grandmas stayed for a while last night and were here for a good portion of the day today too. It was so nice to have them here and share this exciting time with them!

The girls are doing very well, considering they were born 10 weeks prematurely. Evelyn (baby A) weighed in at 3 lb., 3 oz. and Sophie (baby B) weighed 2 lb. 7 oz. The estimates from the ultrasound we had 4 days prior were right on! The biggest concern for early babies is their respiratory status. Their lungs aren't fully developed, and it just takes some time for them to be able to breathe like a term baby would. All day yesterday and until this afternoon, the girls were both on CPAP, but when their oxygen requirements increased today, the decision was made to put a breathing tube down so that the doctors could administer surfactant right into their lungs. Surfactant is a chemical that helps to keep the air sacs in the lungs open, and babies don't produce a whole lot of it on their own when they're as young as Evie and Sophie. The steroids I received before delivery are meant to stimulate surfactant production, but the girls needed even more... they are hoping that, now that the girls have gotten their surfactant, the breathing tubes can be removed within the next day or two.

Since 30 weekers haven't yet learned to coordinate sucking/swallowing/breathing, they each have a feeding tube that goes into their stomach that can be used for breastmilk (and formula, if more calories are needed). For now, they are also receiving nutrition through their central lines, which will be discontinued after a while. In a few weeks, hopefully, we will be able to breast feed and/or bottle feed.

We're aware that things could have turned out much differently for our two peanuts. We thank God that they have arrived safely, and that they seem to be doing as well as expected for 30 weekers! We could not be more in love with our little miracles. Thank you, thank you, THANK YOU for praying us through this rough time.

I'll post pictures soon, but for now, I'm going to go snuggle my daughters. :)

Stabilized

Wednesday night was a rough one for me. Although the contractions I was having weren't painful, they were consistently 1-3 minutes apart, which became concerning for the doctors after a few hours. They decided to put me on a medication called magnesium sulfate to stop the contractions. This drug is also useful for protecting the babies neurologically if they were to be born before 32 weeks. The problem is, the magnesium has a lot of side effects, like hot flashes, nausea, muscle weakness, grogginess, etc. and it can depress your reflexes and decrease your blood pressure. Because of all this, you have to be on STRICT bedrest while on this medication, and they only allow you to eat ice chips and small sips of clear liquids. We were told they were going to put me on it and reevaluate after 24 hours. I quickly ate something and took a shower before starting the drip, knowing that I'd be in bed and hungry for at least the next day.

The first half hour of the drug is a "loading dose," where they give you 6 grams of the magnesium over a half hour. After that, you receive 2 grams per hour. On top of feeling crappy, I had to be hooked up to a blood pressure cuff, pulse ox, 2 IV lines, and 3 monitors on my belly the entire time. Not ideal for sleeping. If a baby moved (which they did a lot), the nurse quickly came in to adjust the monitor. In addition, my blood pressure was checked every hour, temperature every 2 hours, and reflexes every 2 hours. Luckily, my contractions slowed down nicely, and in the middle of the night, the chief resident came in to tell me that they were going to consider shutting the magnesium off in the morning. I had only gotten 45 minutes of sleep the entire night, so we were ecstatic that they decided to turn it off yesterday, only 14 hours after starting it. :)

(PS -- I complain a lot about having to be on the magnesium, but we are actually very thankful that it did such a nice job of slowing the contractions down and for its neuroprotective properties for the babies. We just hope that I won't have to be put on it again. :) )

Things have been looking up since I was taken off the magnesium. Since the babies looked great throughout the entire thing, they took me off continuous fetal monitoring, and now they are just going to monitor the babies for about an hour per day. After the contractions slowed down, they decided I didn't need an uncomfortable labor and delivery bed (with a hard bar behind your back) and my nurse yesterday hooked me up with a new comfy bed with an egg crate mattress cover. Score! I slept over 8 hours last night, so I'm feeling much better now.

The monitor is off!

Trying to get the babies to hold still

Nate keeping himself (and me) entertained

Our room. Everyone's sign is color coded. Pink happens to mean that you're not supposed to be having a baby/babies anytime soon. We hope our sign will stay pink for a few more weeks and not change to yellow (labor).

We are just playing the waiting game now and trying to keep ourselves occupied. We are looking forward to some visitors this weekend. Thanks for your prayers!

Sara & Nate and the Girls

Change of Plans...

This morning when I woke up, I noticed that I was leaking some fluid. I called the nurse in labor and delivery, and she talked to my doctor, who wanted me to come in to be evaluated. So, Nate and I made the trip to Ann Arbor and checked in to triage, where they did a few tests and confirmed that my water had broken.

I have been admitted, and will remain in the hospital until the babies are born. When will that be? That is a great question!! As of right now, I am having contractions every 2-3 minutes, but since they're not painful (and at times I can barely feel them), they're not considering it labor. If I do go into labor, if it looks like I have an infection, or if the babies start looking not-so-great, they'll deliver the babies immediately. If not, our delivery goal is still 34 weeks. We will be here until whenever we deliver!

I got my first dose of steroids to help mature the babies' lungs and other organ systems this afternoon, and I'll get the second dose tomorrow. I've also been started on IV antibiotics to help ward off infection, since the amniotic membrane has now been broken.

Our doctor just came in and did a quick ultrasound, and everything looks great. It looks like it was Baby A's sac that broke, which makes sense since hers is the one that has been poked and prodded multiple times (laser surgery + 2 blood transfusions.) I am also hooked up to a monitor that constantly watches both babies' heart rates and my contractions...

We are obviously praying that our babies will get a few more weeks inside, but thankfully, we were told yesterday that if our babies were to be born right now, they would most likely be in the hospital for a while but have very few, if any, long term complications.

We need your prayers more now than ever! Please pray for our little ones. Thank you all!

Here is a pic of our new home... :)

Grow, Babies, Grow!

Not that we're taking it for granted, but it's been almost 2 months since Baby A needed to have a blood transfusion, so we've come to almost expect dopplers, bladders, and fluid to be normal on each weekly ultrasound. Today, all these things were normal again (prayers answered!)

Our more immediate concern lately has been growth, particularly Baby B's. Today, they estimated Baby B's weight at 2 pounds, 7 ounces, which is a gain of 10 ounces from 2 weeks ago. This puts her in the 4th percentile (still just a little peanut, but the 4th percentile is better than less than the 3rd percentile!) The docs are happy with her progress! Baby A's weight is estimated at 3 pounds, 3 ounces, which means she gained a whole pound in two weeks! She is now in the 49th percentile. If this pattern keeps up, our doctors are hopeful and confident that we will make it to our goal of 34 weeks (only 4 1/2 weeks away!!)

My blood pressure is back down to where it normally is, and I haven't been experiencing any swelling that would be considered abnormal during pregnancy. They're still keeping an eye on it, but the immediate concern of preeclampsia is gone (more prayers answered!) I start my nonstress tests this Friday. If the results of any ultrasound or nonstress test from here on out happen to be concerning, which we're not planning on, they would most likely give me steroid shots to help mature the babies' lungs (two doses, 24 hours apart) and deliver the babies. If not, the shots will probably be given sometime around 33ish weeks so that they are most effective for a delivery at 34 weeks. It is CRAZY exciting to think that, even if everything goes as planned, our babies will be here in a month!

Thank you for praying. We are getting close!
Nate, Sara, and Babies

Getting Closer...

Our little fighters looked great on our ultrasound this morning!! Fluid and dopplers looked normal. Growth was not checked, because the margin of error in the weight measurements makes it silly to check each week. Up until now, growth has been checked every 3 weeks... starting next week, it will be checked every other week. The babies were certainly moving around a lot, and Baby B has made her home underneath the right side of my rib cage... not the most comfortable, but I'll live. My blood pressure was also much better today!

A profile picture of Baby A

After our ultrasound, we got a quick tour of the NICU at U of M. It seems like a great place, and they really do whatever they can to accommodate parents who have a baby/babies there, but being 2 1/2 hours from home is still not ideal for us. We are working on getting a tour/meeting set up with the NICU at DeVos, so that we can be prepared for whatever happens. If we get closer to our new "due date" and things still look stable, we will likely look into having the babies in Grand Rapids.

We also had our fetal echocardiograms today. Twins are at a slightly higher risk for congenital heart defects than single babies, and the recipient twin in TTTS (baby A) is at risk for heart failure due to fluid overload. Our regular doctors are trained to look at the contractility, function, etc. of babies' hearts on ultrasound, and they didn't see any problems, but they referred us to a pediatric cardiologist just to be sure. We were told to prepare for the test to take at least 2 hours. From my perspective, it felt no different from an ultrasound, and I had no idea how I was going to lay on one of those tables for 2 hours. Fortunately for me, the table was more like a really comfy bed, and the test only took about 45 minutes. The even better news was that the anatomy AND function of both the girls' hearts is completely normal! It's such a relief to know that, when the babies are born, we won't be dealing with any major heart issues on top of any other problems they may have. The peds cardiologist did warn us that some minor heart defects can't be detected by an echocardiogram, but anything major has been ruled out!

Since my last post, we've also hit our big 28 week milestone. Ever since our surgery (which was more than 11 weeks ago now!), our doctor has been talking about 28 weeks, and how it is such a big deal to get there. Well, we're there and still truckin' along! At maximum, our babies will be here in 5 1/2 weeks! We just can't wait.

Next week Tuesday is our next ultrasound and a consultation with a neonatologist to follow.

28 Weeks

Thanks for all your thoughts, prayers, and support!

The VPs

Update

My creative juices must not be flowing today, because I can't think of a better title than that. Anyways...

Our ultrasound today revealed normal fluid, bladders, and dopplers (bloodflow). All of our prayers continue to work. Yay!

Since it had been 3 weeks since the last time the babies' growth was checked, they also took these measurements today. Baby A is weighing in at a whopping 2 pounds, 3 ounces, and Baby B at 1 pound, 13 ounces. This puts Baby A at the 25th percentile and Baby B at less than the 3rd percentile.

"I'm just a little peanut!"

Since she's still growing, our doctor isn't immediately concerned about Baby B's size, but it warrants closer monitoring than what we've been having. Being less than the 10th percentile for weight, she's considered "growth-restricted," which puts her at higher risk for developing problems in utero. If we start to see evidence that she's having trouble (there is none now) or her growth stops, it will be time to deliver both babies. Next week Wednesday, we will have our normal weekly ultrasound with a nonstress test, and starting the following week, we will go to Ann Arbor twice a week, with a nonstress test scheduled on the extra day, which always happens to be Fridays. Also next week, we will have a tour of the NICU and our fetal echocardiogram, which is just a fancy word for a really detailed ultrasound of the babies' hearts. Like I said before, from what our docs can tell, there aren't any issues with their hearts, but this test will tell us for sure.

I've been developing some swelling in my feet and hands (I pried my wedding ring off today, and it's not going back on any time soon... and yes, I have cankles... real sexy.) On top of that, my blood pressure is up about 20 points from where it normally is. It's still not in the range to diagnose preeclampsia, but we are now being watched closely for that too. I had labs checked today and they all came back normal, so they'll use today's numbers as a baseline and check every so often to make sure I'm not developing preeclampsia. We are very thankful that everything is checking out so far!

We're praying that these babies get 6 more weeks in there, but with possible growth issues and my blood pressure being a concern, we have no idea how much longer they'll have. As an added precaution with all the news we got today, I've officially been taken off work until after my maternity leave. I'm going to do my best to rest, rest, rest in hopes that my blood pressure will stabilize and I won't go into labor anytime soon.

Thank you, thank you, thank you for continuing to pray for our sweet little girls!
Nate, Sara, and the Babies who shall remain unnamed. :)

"Well-Behaved Babies"

That is how our doctor introduced us to a visiting OB who sat in on our visit today... "Meet Sara and Nate Vander Ploeg and their well-behaved babies." I LOVE having well-behaved babies!!

You're probably sick of reading the same things each week lately, but I'll NEVER get sick of writing it, so here goes...

• Babies A and B have normal fluid levels
• Babies A and B have normal bladders
• Babies A and B have normal bloodflow (until today, Baby A's was always on the high end of normal and Baby B's was on the low end of normal... today, they are both much closer to the "average" normal value. YAY!)
• We can tell the girls are growing, even though we won't get official measurements again until next week.

Baby A - profile view

Baby B looking straight at the camera!

My doc was happy to hear me say that I'm getting more and more uncomfortable and that it's getting harder and harder to move around. In her words, she loves seeing me "super pregnant," and I have to be honest, I love BEING super pregnant, considering a couple months ago we were just praying our babies would live. We only have, at the max, 7 1/2 weeks left before our little bundles arrive... I am so excited to hold them!

The nursery is coming together. The cribs and dresser are assembled, and we just picked up our chair today. I had to do some work when we got home, so I decided to set up in the nursery and break in the new chair. I'm still sitting in it right now, and I'm imagining what it's going to be like with two babies in this room. I have a feeling I'm going to want to sit in here and stare at them while they sleep... good thing this chair is comfy!

My friend Mandy from work arranged for everyone who was interested to buy a "Fight TTTS" bracelet to support TTTS awareness and research. About 30 people bought bracelets, and even more are interested now, including lots of family members! I'll be putting in another order for more bracelets, so if anyone wants one, let me know (they're $5)! We think it's such a cool way for people to support us and our babies, and parents who have been and will be in our situation.

Our next appointment is next Tuesday, 3/11. We will keep you posted!

Thanks, as always, for all the thoughts and prayers!

Nate & Sara and the babes